Clinical, electrophysiological, and cutaneous innervation changes in patients with bortezomib-induced peripheral neuropathy reveal insight into mechanisms of neuropathic pain

Molecular Pain
Malik BechakraJoost Lm Jongen

Abstract

Bortezomib is a mainstay of therapy for multiple myeloma, frequently complicated by painful neuropathy. The objective of this study was to describe clinical, electrophysiological, and pathological changes of bortezomib-induced peripheral neuropathy (BiPN) in detail and to correlate pathological changes with pain descriptors. Clinical data, nerve conduction studies, and lower leg skin biopsies were collected from 22 BiPN patients. Skin sections were immunostained using anti-protein gene product 9.5 (PGP9.5) and calcitonin gene-related peptide (CGRP) antibodies. Cumulative bortezomib dose and clinical assessment scales indicated light-moderate sensory neuropathy. Pain intensity >4 (numerical rating scale) was present in 77% of the patients. Median pain intensity and overall McGill Pain Questionnaire (MPQ) sum scores indicated moderate to severe neuropathic pain. Sural nerve sensory nerve action potentials were abnormal in 86%, while intraepidermal nerve fiber densities of PGP9.5 and CGRP were not significantly different from healthy controls. However, subepidermal nerve fiber density (SENFD) of PGP9.5 was significantly decreased and the axonal swelling ratio, a predictor of neuropathy, and upper dermis nerve fiber density (UDNFD)...Continue Reading

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Citations

Apr 30, 2019·Scandinavian Journal of Pain·Nina Stockfleth BuchPáll Karlsson
Dec 22, 2019·Cancers·Flaminia ColuzziSebastiano Mercadante
Jan 21, 2021·Proceedings of the National Academy of Sciences of the United States of America·Maria Elena PeroFrancesca Bartolini
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Oct 17, 2021·Oncology and Therapy·Jamie BurgessUazman Alam

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Methods Mentioned

BETA
biopsies
biopsy

Clinical Trials Mentioned

NCT00956033

Software Mentioned

ImageScope
Leica Aperio ImageScope
SPSS Statistics

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